Brody should know: He’s one of the world’s foremost experts on the treatment of severe concussions. I also witnessed it myself.

Earlier this year, a Toronto-area youth suffered what would be diagnosed as a “very mild” concussion — about as mild as they come, in fact. Only there was nothing “mild” about it.

I was able to follow this soccer player’s weeks-long recovery and cutting-edge treatment at a Toronto sports medicine clinic. I am not identifying the patient by name, age or home town, at the parents’ and preteen’s request. A primary reason is they don’t want the child’s concussion history entered into the public record.

It is only with the family’s permission that I can share their story: Of the harrowing, uncertain first hours and days; of the symptoms felt by the athlete, which sometimes worsened in an eyeblink; of the worry, ignorance, frustration and inadequacy felt by the parents.

The family hopes that by sharing the plight of the athlete — whom we’ll call Owen — they can perhaps better prepare others for the ordeal.

Owen was one of the lucky ones. Recovery in most cases takes a couple of weeks. But life for the most severely concussed is pure hell, for as long as a year.

Karam and the SMS clinic granted me permission to reveal what I observed during Owen’s treatments.

Here is his story.

THE INCIDENT

Owen likes to think he has a high tolerance for pain.

“But that hurt. It really hurt,” he said of the freak accident that concussed him last spring, at an out-of-town soccer tournament in the U.S.

It happened during the pre-game warmup on Day 2 of the competition. A fast-flying ball smacked hard off Owen’s forehead, just above his right eye. He saw the crosser coming, he just misjudged it. Thus, he didn’t do anything to protect himself.

There was no cut, surface swelling or bruising. But the pain Owen felt was immediate, sharp and intense. He could not stop crying for a time.

Owen’s coach, to his compassionate credit, immediately ruled Owen out of the big afternoon game.

Owen wasn’t wobbly or groggy. Soon his eyes dried, his demeanour brightened and he no longer seemed to be in any particular discomfort. His parents had no idea what to do next. Just give him an Advil or two, head back to the hotel and have him rest up under their close observation? Or take him to emergency, just to be safe?

The tournament had a paramedic on site, so they started there. She briefly examined and questioned Owen and concluded, by that state’s medical definition, he was concussed. His tournament was over.

The paramedic provided Owen’s parents with detailed short-term medical advice, which advocated — shockingly to Owen’s parents — no headache pills or medication. The reason? Some over-the-counter headache medicine can exacerbate internal bleeding of the brain, in the unlikely event that was occurring.

Back at the hotel, Owen relaxed in bed for the remainder of the day, experiencing no symptoms other than a gradually dissipating headache.

In bed, he ate a bit of dinner and watched some TV before lights out. He slept fine.

Owen awoke cheerily with just a slight headache. Good news. Maybe he was better. It didn’t seem like a concussion.

And, boy, was he hungry. Downstairs at the hotel’s complimentary breakfast station, Owen loaded up a foam plate and sat down to dig in with plasticware. Youth and parents from other teams packed the chaotic breakfast area.

That fast, Owen’s cheery morning ended.

“All the noise — all those players yakking — really hurt my head,” he recalls. “Just like that, I felt dizzy. Really dizzy. Felt like I was going to throw up. I said to Mom and Dad, ‘I gotta get out of here. Like, right now.’ ”

It was drive-home day. The family SUV was already packed.

What to do? Was propping up Owen in the back seat, immobilized against a pile of home-brought pillows, the best place for him to be for most of the day? Or the worst, weaving down highways all day at high speed?

Again, his parents had no idea. This was their scariest, most stressful moment of the crisis. What if Owen was severely hurt? What if he couldn’t continue the drive at some point, in the middle of nowhere?

They decided to rely on what the paramedic had suggested — immobility and rest — and at least try to drive home, prepared to find a hospital at any moment.

Owen, on the verge of tears and feeling awful, fell asleep almost immediately upon hitting the Interstate. He awoke two hours later, his dizziness and nausea gone. It remained gone for the rest of the day. Same with the bad headache.

Owen’s disposition kept improving as the SUV’s odometer spun. By the time the family neared home at twilight, he was sitting upright in the back seat, laughing and getting into trouble with a sibling, playing on an iPad and seemingly back to normal.

Crisis averted?

It seemed so. But it wasn’t even close.

NO SCHOOL

After a decent night’s sleep in his own bed, Owen’s sensitivity to noise returned. And it remained. Worse, he found if he jerked his head, or moved quickly, his head hurt. Not a lot, but there was definitely pain.

Owen’s parents continued to follow the tournament paramedic’s advice and did not give him any headache medication, as counter-intuitive as that seemed. The day’s priority: Get him to a concussion doctor, stat.

First, though, they called his school to say Owen might have a concussion and wouldn’t be attending classes that day.

That’s when Owen’s parents learned that, in publicly funded schools in Ontario, if you tell the school your kid might have a concussion, a strict concussion-management protocol kicks in. The Ontario government decreed in 2014 that the return-to-school protocol devised and approved by the Ontario Physical and Health Education Association must be the minimum standard employed by all local school boards.

Ontario is the only province with such legislation in place.

The bottom line: Your child can only return — and perform activities at clearly defined levels — with a doctor’s permission.

In Owen’s school district, a doctor must fill out and sign a four-page concussion-management protocol form, indicating which of the eight stages the child is at, which cerebral or physical activities the child can perform, and whether monitoring is required.

The parents scrambled to find a nearby concussion doctor or therapist, consulting Google, Yellow Pages and friends. They called every clinic within a 30-km radius of their family home, only to find all were booked up for one-to-two weeks.

Concussion epidemic, indeed.

Finally, the parents secured an appointment the next day for Owen to see Siobhan Karam at Toronto’s SMS clinic.

As for his first day home, Owen spent it idle, watching some TV, but mostly passing time on his iPad.

THE ASSESSMENT

Upon waking, Owen’s symptoms were unchanged. Sudden movements made his head hurt, as did loud noises.

Owen’s father accompanied him to the SMS clinic. After reviewing Owen’s detailed medical history, Karam proceeded with her usual assessment, which included:

Identifying Owen’s symptoms and applying a severity rating to each.

Nine neurological symptom tests, including for dizziness, nausea and numbness.

Seven neck assessments, to see whether such movements as active range of motion, rotation and key reflexes were affected.

Four vertebral (neck) artery function tests.

Six balance and vision tests, more formally called vestibular and ocular motor screening. (See sidebar)

Next, an SMS physician examined Owen, concurred with Karam’s assessment and filled out the school board’s concussion protocol form. Owen could return, half-days, at Stage 4 of 8: “A gradual increased exposure to visual and auditory distractions,” with monitoring.

Karam then walked Owen through the newly developed vision and balance exercises he was to perform at home, twice a day, over the next eight days, until his next appointment.

Her principle advice to Owen for the next week: No physical activity whatsoever; lots of rest; and stay off the iPad and other electronics. The iPad edict distressed Owen more than anything he’d heard so far, but it’s important not to over-stimulate, and thus fatigue, the brain as it reboots.

Owen and his father exhaled on the way out. Relief.

But while Owen’s head was healing, his dad’s was spinning.

THE RETURN TO SCHOOL

Owen felt almost 100 per cent on Day 5. There was no headache, not even when he jerked his head or moved suddenly. The noise sensitivity also seemed gone.

His parents decided to let him return to school that afternoon, on the limited basis approved by Karam and the SMS physician.

But not even 15 minutes after Owen’s mom dropped him off, the school rang: Owen needed to be picked up immediately. He had a bad headache.

“The classroom was SO loud during lunch,” he recalled. “My head hurt right away. I had to get out of there.”

Back home, Owen spent the rest of the day relaxing, and somewhat grudgingly did his laser exercises.

Owen’s parents kept him home on Day 6, a Friday.

His concussion symptoms never returned, not even noise aversion. After a quiet weekend, Owen spent half-days at school on Days 9-11, without setback.

THE FOLLOWUP CLINIC VISIT

Karam examined Owen again on Day 12.

Satisfied he was symptom-free, she asked Owen to work out on a treadmill for 15 minutes, to see if light physical activity bothered him. Owen got up to 5.5 mph at a Level 15 incline. Not bad.

Then Karam watched closely as Owen performed physical agility tests. Still no headaches, nor any other symptoms.

At that point, and after an SMS physician’s exam, Owen and his parents received the news they’d been hoping to hear: Owen was cleared to return to school full-time (Stage 8 clearance), and to resume physical activity.

THE RETURN TO PLAY

Karam advised Owen to return to play on his elite team, but gradually.

For his first two weeks back, Owen did not dress for games — his parents’ decision, with his soccer coach’s support. Owen practised only in non-contact technical drills, all without issue.

A day before Owen’s return to game action, Karam examined him one last time, on Day 23. She put him through high-intensity exercises — 15 minutes on the treadmill, 15 minutes on the rowing machine — followed by a few sport-specific workout and technical drills, such as passing and receiving.

There were still no symptoms, no headaches, no issues.

Owen’s coach worked him back into game action gradually over the next two weeks, without incident.

Five weeks later, his “mild” traumatic brain injury crisis was over.

EYE TESTS LATEST TOOLS TO GAUGE CONCUSSIONS

The most eye-opening portion of Siobhan Karam’s examination of Owen involved, well, his eyes.

These tests are so new, the most recent concussion-diagnosis protocol employed the world over — SCAT 3 (Standardized Concussion Assessment Tool, third version) — doesn’t include them. And yet they’re as fascinating, and perhaps as revelatory, as they are simple.

One is called Smooth Pursuits. With head still, the patient’s eyes follow an object (usually the examiner’s pen or finger) from left to right, clear across the patient’s field of vision. Owen did this no problem.

Next, Karam turned Owen’s head from side to side while asking him to focus on her nose. He didn’t pass this test. His eyes fluttered slightly as he tried to focus. We could see it; he couldn’t feel it.

“It’s called Nystagmus,” Karam said. “It is a positive finding for vestibular ocular reflex — the VOR. It can be a telltale sign that something’s wrong with the central processing system. It doesn’t necessarily mean the person is concussed. It could mean he had some existing condition such as dyslexia, ADHD or cervical dysfunction.”

Another of Karam’s simple ocular motor function tests is called Near Point of Convergence. She holds a pen about two feet from the patient’s nose, tells the patient to focus only on the pen, then she gradually brings it closer to his nose, until the patient sees two pens. “The norm for seeing two objects is within 3-4 cm of your nose,” she said.

Owen passed that test. Those who fail it see two objects, sometimes much farther away. Anything beyond 6 cm could be a flag for medical personnel.

In still another vision test, Karam held her two index fingers far apart. Owen, with head still, rapidly switched focus, back and forth, between the two fingers. He encountered no problems, felt no discomfort and passed this test, too.

“With some concussion patients, eye movement can be really slow,” Karam said. “They’ll have trouble switching their eyes back and forth. Some will say, ‘I can’t do this. My head hurts.’ With concussions, the big problems we sometimes see are with the eyes. Not just blurred vision, but dizziness, nausea — that comes when you don’t feel balanced, when your eyes aren’t helping you stabilize.”

Karam then walked Owen through newly developed vision and balance exercises he was to perform at home. Owen donned a headband with an attached red laser aiming straight ahead. He stood about six feet from a wall.

In the first exercise, he tried as best he could, by moving only his head, to trace with the laser’s red-dot light all the letters of the alphabet, each about 3 cm deep on a sheet Karam posted on the wall, head high.

Next, she posted another sheet, this one with pictured rings — like the house in curling. With eyes closed, Owen had to lift one leg off the floor, turn his head all the way to one side, then swing it back straight on, trying to place the laser light inside the smallest two rings.

Owen repeated with the other leg, with head swinging in both directions. He didn’t do too well on this one.

The purpose of these tests? Rehab.

Most in the medical community have long believed that concussion patients should stimulate their brains as little as possible during recovery. That is, the more time spent immobile — in a dark, quiet room if necessary — the better.

Now, some concussion experts endorse limited, careful, specific rehabilitation therapy exercises, such as the ones Karam and SMS offer. Karam said she is encouraged by the results.

“The laser point is just a cheap way to have something moving. And then we coordinate those with neck exercises,” she said. “They’re habituation exercises. Our body adapts to meet the needs of stresses. Let’s say we work out to our anaerobic threshold. The body takes the physiological time it needs to heal from that, and then the next time you go to do the same thing, you can do it at a higher level. But if you go too far, you can over-train and even injure yourself.

“Brains are the same way, except they’re very, very, very sensitive. So we basically are asking patients to do exercises based on what we require in everyday life. It’s training your brain to do a particular exercise at the highest level you can that day, so your body gets used to having that demand. Then it should become easier.”

FROM MILD TO THE VERY WORST

If Owen’s concussion was “very mild,” how bad can it get?

Physiotherapist Siobhan Karam explained that many concussion sufferers recover within two weeks.

“But I’ve been seeing more and more young patients take between four-to-six weeks to fully recover,” she said.

Beyond four weeks can mean you have “post-concussion syndrome” (an umbrella term experts now dislike, as it improperly describes markedly different conditions and diagnoses).

Life is hell for these sufferers.

“They just can’t function,” Karam said. “They can’t return to life. Some feel like they’re going to fall over, all the time. They can’t drive.

“In the most extreme cases, these patients feel like they’re always on a boat — for months. They always feel nauseated, like someone’s always pushing them. It would be like being seasick or hung over all the time. All you want to do is sleep. But you don’t feel better when you wake up. It’s awful.”